• Hee-Nee Pang, Renyi Benjamin Seah, and Steven J MacDonald.
• Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.
• Knee. 2015 Oct 1; 22 (5): 440-2.

BackgroundWe present a case of multifocal infection involving the left total hip replacement and the right total knee replacement of a patient, further complicated by an infected non-union of a periprosthetic fracture of the right knee. This required the unique simultaneous management of both infection eradication and fracture stabilization in the knee.MethodsBoth sites were treated with a two-stages procedure, including the novel use of a stemmed articulating spacer for the right knee. This spacer was made combining a retrograde humeral nail, coated with antibiotic-impregnated cement, and a pre-formed articulating cement spacer. The patient was able to weight-bear on this spacer.ResultsThe fracture went on to unite, and a second stage was performed with the use of stemmed prosthesis and augments. She remains infection free two years after the second stage operation.ConclusionsThe use of a stemmed articulating knee spacer can facilitate infection eradication and fracture stabilization while preserving some motion and weight-bearing ability in the two-stages management of an infected periprosthetic fracture of the knee.Level Of EvidenceLevel V (Case report).Copyright © 2015 Elsevier B.V. All rights reserved.

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